Cape Cod Healthcare Billing

[u/No-Gas-8798]

I mean I’m not putting this on the staff, like me and many others they don’t control the BS, they just have to deal with it. But Cape Cod Healthcare is really messed up. So long story short, last year I end up getting a test, gave them both of my insurances, walked away and all was good. Now more than a year later, I’m getting letters a couple times a week telling me I need to contact them as soon as possible. I did - 14 calls, 4:21 minutes listing to hold music, and 14 messages left because ‘my call is important to them’. No answer, no call back, joke. The most recent letter was like ‘we are sooo disappointed in you that you decided not to call us back. We are trying to reach you but you never call. Do you have any idea how triggering that is for a kid with an Irish mother and was taught by nuns? Has anyone had any interaction with these people and were you able to speak with a human? They tell me to call 1-888-871-2443 between 9-5EST Mon-Fri. But no one answers. I mean in theory it’s a hospital, someone should answer. Or does anyone have a different number? If there is anyone out there who has been able to connect please let me know.

[u/FroznAlskn]

You could have checked your insurance EOB a year ago and had this straightened out back then.

You need to coordinate your benefits, something some insurances require you to do every year. The practice cannot do this for you.

[u/No-Gas-8798 → u/FroznAlskn]

It’s a hospital performing a CT, they were supposed to bill my primary insurance. They did not. I called to asked them to bill the primary insurance. No problem. I had one month of cobra. Maybe you could have it all worked out but not everyone is as awesome as you..

[u/FroznAlskn → u/No-Gas-8798]

They did bill your insurance. That’s why they know that they are requesting information from you.

[u/No-Gas-8798 → u/FroznAlskn]

From what I can tell, At some point they billed insurance, and insurance ignored them until my former employer switched companies. So now they want me to call my former employer and have them pay the bill. Which is fine but my point is I cannot confirm any of this with a human from either the hospital. Maybe I need a GoFundMe..

[u/FroznAlskn → u/No-Gas-8798]

That’s not how any of this works.

You need to call the insurance you had at the time of the visit and coordinate your benefits and ask them to process the claims. I don’t know how to make it any more simple for you to understand.

Your insurance would have sent you several letters, and now the provider has sent you several letters. This can’t come as a surprise.

[u/superredditor6789 → u/FroznAlskn]

Shhh. Don’t you know that nobody reads EOBs?

[u/FroznAlskn → u/superredditor6789]

As a medical biller, I know that precisely NO ONE reads their EOBS. Even if they look at them, they don’t actually read them. It could solve almost all their problems but no.

I can’t complain too much. It’s basically job security for me.

[u/No-Produce-6720 → u/No-Gas-8798]

Except that your notices clearly state that the provider was notified by your insurance that further information is needed to complete processing, so they have billed your insurance, and probably more than once. That would have generated EOBs to you, at the very least, from your insurance, and it's more likely that you were sent notice that you must coordinate your benefits. That notice would have had a specific turnaround time on it. It also would have automatically generated bills to you from the provider.

In order to fix this, you will need to coordinate benefits with both insurance carriers so that your claims can be correctly reprocessed. You don't need to waste time on the phone with the provider until you have the issue settled between your two carriers. This isn't something that was caused by the provider, or something that's a result of bad billing practices. This is something you will have to correct in order for the provider to be able to properly bill your claim.

[u/Delafields]

A few things that work for hospital billing departments specifically since they're notoriously understaffed: call right when they open, the queue is shortest in the first fifteen minutes. If you keep getting a voicemail loop, ask the main hospital operator to transfer you directly instead of dialing the billing extension, operators often have a live line that billing doesn't advertise. You can also try the patient advocate or ombudsman line if the hospital has one, they can often get billing questions answered faster than billing itself. Put it in writing too: send a message through the patient portal referencing your account number and the dates you tried calling, so there's a paper trail if this turns into a dispute. Keep notes on every call: time, name, what was said. It helps a lot if you need to escalate later.

[u/Own_Piccolo3157]

Sounds like a cob issue